"Thrombosis takedown, safeguarding your journey": QI project to raise Venous Thromboembolism (VTE) awareness among staff and patients at Hamad International Airport, North Node Clinic

Background

Venous thromboembolism (VTE) is the underlying cause of 1 in 4 deaths worldwide, the third leading cause of cardiovascular deaths and the number one cause of preventable deaths in hospitalized patients. VTE, encompassing deep vein thrombosis (DVT), and the potentially fatal pulmonary embolism (PE), has a 5-10% mortality risk, up to 30% recurrence risk, and significant potential sequelae, including pulmonary hypertension and heart failure. Air travel carries a relative VTE risk 2.8 times higher than the general population risk of 1/1,000. Furthermore, VTE risk increases by 26% for each two hours of added air travel, from over four hours. Hamad International Airport (HIA) North Node Clinic (NNC) is an acute medical clinic, located within one of the world’s busiest international airports. The aim of this Quality Improvement (QI) project is to place VTE firmly on the radar of both NNC staff and patients, primarily transiting air travelers, via enhanced VTE risk assessment and patient education.

Methods

The first step of this QI project was to collect baseline VTE data, via an audit of transferred patients from NNC to the Emergency Department, spanning January 1st to December 31st, 2022.

Results

There were 10 proven VTE cases from a total of 696 passengers transferred from NNC to ED (Figure 1). This VTE incidence of 14.37/1,000 was significantly higher than the 1/1,000 general population VTE incidence. Clinical concordance between referring diagnosis of suspected VTE and final VTE diagnosis was only 3.8%, highlighting the non-specificity of VTE presentation and thus importance of proactive VTE risk assessment (Figure 2).

Conclusion

VTE awareness among NNC staff and passengers is vital to both pre-empt and safely manage this potentially fatal, but largely preventable, disease. The next steps in this QI project will be to create a bedside VTE screening tool, then a VTE patient education tool.